2024 Counselor STEM Camp Registration Form
*Please complete this form to register to be a counselor for the 2024 STEM Summer Camp. 
*It is a 3 day camp on JUNE 17, 18, 20 from 8 AM to 5 PM. 
*Training is 1 day, but offered on 2 different dates from 11 am to 12 pm on June 3rd or 4th.
*Please fill out each section of the form to complete the application process. 
*You will receive a confirmation once the form is submitted. 
*Submitting this form will ensure your spot is saved for our camp and will initiate you receiving future emails soon with more detailed camp information.
Sign in to Google to save your progress. Learn more
Email *
Untitled Title
No transportation will be provided. Will you be able to provide your own transportation to and from camp? *
LAST NAME *
FIRST NAME *
What grade are you currently in? *
Required
What school do you attend? *
Address (street, city, zip code): *
Name of Parent/Guardian: *
Email Address of Parent/Guardian: *
Home OR Cell Phone Number of Parent/Guardian:   *
Work Phone of Parent/Guardian : *
Emergency Contact Name: *
Emergency Phone Number: *
What grade do you prefer to assist? Select at least 4 grades. *
What other counselor would you like to work with? I will try my best to accommodate your request. *
What day would you like to attend training? Only make 1 selection. *
Required
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Putnam County School District. Report Abuse
Google Forms